A new American Diabetes Association white paper addressing the high price of insulin recommends ways healthcare providers can help minimize patients’ out-of-pocket costs.

“Insulin Access and Affordability Working Group: Conclusions and Recommendations” was published online in Diabetes Care on Tuesday, purposely coinciding with a hearing on the rising costs of insulin held by the U.S Senate Special Committee on Aging.

 “The average list price of insulin has skyrocketed in recent years, nearly tripling between 2002 and 2013,” the working group reports. “The reasons for this increase are not entirely clear but are due in part to the complexity of drug pricing in general and of insulin pricing in particular.”

At the hearing, Sen. Susan Collins (R-ME) called rate hikes, even for the drug’s oldest versions, “untenable.”

“It’s become a barrier to treatment for so many Americans,” Collins noted. “Why aren’t discounts negotiated with manufacturers reaching the patient, particularly the uninsured patient, but also the patients with insurance and a high deductible?”

The ADA warns healthcare providers to be mindful that rising prices may make community-dwelling diabetics less likely to follow their treatment plans, noting they should “appropriately prescribe all forms of insulin preparations based on evidence-based medicine.”

Diabetes not well controlled can lead to serious consequences such as heart disease, stroke, vision problems and amputations, all of which can lead to a need for more intensive healthcare such as skilled nursing.

 The ADA’s working group called for transparency throughout the insulin supply chain and also aimed its recommendations at insulin manufacturers, pharmacies, health plans and pharmacy benefit managers.